L89.894: Pressure ulcer of other site, stage 4
L89.894, pressure ulcer of other site, stage 4, is listed as a covered diagnosis in 3 Medicare billing and coding articles that apply to 8 HCPCS Level II codes, including E0194 (Air fluidized bed), G0281 (Electrical stimulation, (unattended), to one or more…), G0329 (Electromagnetic therapy, to one or more areas for chronic…). 1 of these codes has a 2026 DMEPOS fee schedule amount; E0194 pays $3,856.78 to $4,884.31 (RR) depending on the state. The articles come from 3 Medicare contractors. A listed diagnosis supports medical necessity only; coverage still depends on the LCD's criteria and on documentation in the medical record.
HCPCS Level II codes with L89.894 as a covered diagnosis
| Code | Description | Medicare coverage | DMEPOS fee 2026 (state range) | Articles listing it |
|---|---|---|---|---|
| E0194 | Air fluidized bed | Special coverage instructions apply | $3,856.78–$4,884.31 (RR) | 1 |
| G0281 | Electrical stimulation, (unattended), to one or more areas, for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers, and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0329 | Electromagnetic therapy, to one or more areas for chronic stage iii and stage iv pressure ulcers, arterial ulcers, diabetic ulcers and venous stasis ulcers not demonstrating measurable signs of healing after 30 days of conventional care as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0283 | Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care | Carrier judgment | — | 1 |
| G0152 | Services performed by a qualified occupational therapist in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0158 | Services performed by a qualified occupational therapist assistant in the home health or hospice setting, each 15 minutes | Carrier judgment | — | 1 |
| G0160 | Services performed by a qualified occupational therapist, in the home health setting, in the establishment or delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
| G2169 | Services performed by an occupational therapist assistant in the home health setting in the delivery of a safe and effective occupational therapy maintenance program, each 15 minutes | Carrier judgment | — | 1 |
Medicare policy articles listing L89.894
- A52468: Pressure Reducing Support Surfaces - Group 3- Policy Article (CGS Administrators, LLC (DME MAC) Noridian Healthcare Solutions, LLC (DME MAC); 1 Level II codes). LCD with the same title: L33692
- A55909: Billing and Coding: Wound Care (WPS Insurance Corporation (MAC - Part A, MAC - Part B); 2 Level II codes). LCD with the same title: L35125, L37166, L37228
- A53057: Billing and Coding: Home Health Occupational Therapy (Palmetto GBA (HHH MAC); 5 Level II codes). LCD with the same title: L34560
A diagnosis listed as covered in a billing and coding article supports medical necessity for the article's codes; it does not guarantee payment. Coverage depends on the LCD's criteria, the contractor's jurisdiction and documentation in the medical record.
Other L89 diagnoses (Pressure ulcer)
- L89.893 — Pressure ulcer of other site, stage 3
- L89.812 — Pressure ulcer of head, stage 2
- L89.813 — Pressure ulcer of head, stage 3
- L89.814 — Pressure ulcer of head, stage 4
- L89.006 — Pressure-induced deep tissue damage of unspecified elbow
- L89.010 — Pressure ulcer of right elbow, unstageable
- L89.011 — Pressure ulcer of right elbow, stage 1
- L89.012 — Pressure ulcer of right elbow, stage 2
- L89.013 — Pressure ulcer of right elbow, stage 3
- L89.014 — Pressure ulcer of right elbow, stage 4
- L89.016 — Pressure-induced deep tissue damage of right elbow
- L89.020 — Pressure ulcer of left elbow, unstageable
- L89.021 — Pressure ulcer of left elbow, stage 1
- L89.022 — Pressure ulcer of left elbow, stage 2
- L89.023 — Pressure ulcer of left elbow, stage 3
- L89.024 — Pressure ulcer of left elbow, stage 4
- L89.026 — Pressure-induced deep tissue damage of left elbow
- L89.103 — Pressure ulcer of unspecified part of back, stage 3
- L89.104 — Pressure ulcer of unspecified part of back, stage 4
- L89.106 — Pressure-induced deep tissue damage of unspecified part of back
- L89.110 — Pressure ulcer of right upper back, unstageable
- L89.111 — Pressure ulcer of right upper back, stage 1
- L89.112 — Pressure ulcer of right upper back, stage 2
- L89.113 — Pressure ulcer of right upper back, stage 3
- L89.114 — Pressure ulcer of right upper back, stage 4
- L89.116 — Pressure-induced deep tissue damage of right upper back
- L89.120 — Pressure ulcer of left upper back, unstageable
- L89.121 — Pressure ulcer of left upper back, stage 1
- L89.122 — Pressure ulcer of left upper back, stage 2
- L89.123 — Pressure ulcer of left upper back, stage 3
Frequently asked questions
Does Medicare cover L89.894 (Pressure ulcer of other site, stage 4)?
Medicare covers items and services, not diagnoses. 3 Medicare billing and coding articles list L89.894 as a covered diagnosis for 8 HCPCS Level II codes: the diagnosis can support medical necessity for those codes, but payment still depends on the LCD's coverage criteria and the medical record.
Which HCPCS codes can be billed with ICD-10 L89.894?
The Level II codes from the policies most specific to this diagnosis are E0194 (Air fluidized bed, 1 article); G0281 (Electrical stimulation, (unattended), to one or more…, 1 article); G0329 (Electromagnetic therapy, to one or more areas for chronic…, 1 article); G0283 (Electrical stimulation (unattended), to one or more areas…, 1 article); G0152 (Services performed by a qualified occupational therapist…, 1 article). Code choice depends on the item supplied; check each code's descriptor.
What does Medicare pay for equipment billed with L89.894?
Under the 2026 DMEPOS fee schedule (non-rural state fees): E0194 $3,856.78 to $4,884.31 (RR). Medicare pays 80% of the allowed amount after the Part B deductible.
Which Medicare policy articles list L89.894?
A52468 (Pressure Reducing Support Surfaces - Group 3- Policy Article); A55909 (Billing and Coding: Wound Care); A53057 (Billing and Coding: Home Health Occupational Therapy).
What is ICD-10-CM code L89.894?
L89.894 is the ICD-10-CM code for pressure ulcer of other site, stage 4, in category L89 (Pressure ulcer), chapter 12: Diseases of the skin and subcutaneous tissue.
Next steps
- Run a reimbursement report for a device billed under E0194
- Watch E0194 for fee, coverage and descriptor changes
- Build a full Medicare revenue model for E0194
Sources: CMS Medicare Coverage Database billing and coding articles (covered ICD-10 code lists and HCPCS links); ICD-10-CM FY2026; CMS HCPCS Level II release October 2026; CMS DMEPOS fee schedule 2026 (non-rural state fees). Not billing or legal advice.
Chapter 12: Diseases of the skin and subcutaneous tissue · All diagnoses · HCPCS lookup